Is bilateral protected specimen brush sampling necessary for the accurate diagnosis of ventilator-associated pneumonia?

@article{Butler2004IsBP,
  title={Is bilateral protected specimen brush sampling necessary for the accurate diagnosis of ventilator-associated pneumonia?},
  author={Karyn L. Butler and Irwin M. Best and Robert A. Oster and Iva Katon-Benitez and Wm Lynn Weaver and Harvey L. Bumpers},
  journal={The Journal of trauma},
  year={2004},
  volume={57 2},
  pages={
          316-22
        },
  url={https://api.semanticscholar.org/CorpusID:7439514}
}
The low concordance between blind and directed PSB suggests the need to sample both lung fields, and bilateral PSB sampling can identify unsuspected pathogenic microorganisms in the contralateral lung.
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8 Citations

Clinical impact of pulmonary sampling site in the diagnosis of ventilator-associated pneumonia: A prospective study using bronchoscopic bronchoalveolar lavage.

Diagnosis of ventilator-associated pneumonia: a systematic review of the literature

An integrated approach should be followed in diagnosing and treating patients with VAP, including early antibiotic therapy and subsequent rectification according to clinical response and results of bacteriologic cultures.

Ventilator-associated pneumonia

Prevention remains the key to reducing VAP prevalence, and limiting the duration of antibiotic treatment to 8 days and antimicrobial rotation should be contemplated.

Colheita de aspirado traqueal para o diagnóstico microbiológico de pneumonia associada à ventilação mecânica : comparação de duas técnicas

Preliminary results did not show significant differences in the results of cultivation of samples through protected and traditional techniques, but raised the necessity for further studies, including analysis of genetic concordance of agents isolated in the endotracheal tube wall and in tracheobronchial secretions.

Nosocomial pneumonia: aetiology, diagnosis and treatment

Purpose of review This review highlights recent advances in the aetiology of nosocomial pneumonia, and in strategies to increase accuracy of diagnosis and antibiotic prescription while limiting…

Guidelines for the management of hospital-acquired pneumonia in the UK: Report of the Working Party on Hospital-Acquired Pneumonia of the British Society for Antimicrobial Chemotherapy

Abstract These evidence-based guidelines have been produced after a systematic literature review of a range of issues involving prevention, diagnosis and treatment of hospital-acquired pneumonia…

Current Issues in Ventilator-Associated Pneumonia

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Empiric broad-spectrum antimicrobials in the ICU for presumed pneumonia has contributed substantially to the worldwide increase in antibiotic-resistant bacteria in hospitals.

Aportación del laboratorio de microbiología al diagnóstico de la neumonía asociada a la ventilación mecánica

El diagnostico etiologico de la neumonia asociada a ventilacion mecanica (NAVM) es una urgencia microbiologica por su repercusion en la morbilidad y mortalidad asociadas a el. La obtencion de…

16 References

A comparison of bronchoscopic vs blind protected specimen brush sampling in patients with suspected ventilator-associated pneumonia.

The results of this study are consistent with the notion that blind PSB sampling and quantitative culture may prove to be a useful, cost-effective, and minimally invasive method of diagnosing VAP.

Clinical Investigations in Critical CareProtected Specimen Brush in the Assessment of Ventilator-Associated Pneumonia: Selection of a Certain Lung Segment for Bronchoscopic Sampling Is Unnecessary

Reliability of the bronchoscopic protected catheter brush in the diagnosis of pneumonia in mechanically ventilated patients

The telescoping plugged catheter demonstrated significant bacterial infection in a relatively small proportion of patients in whom bacterial lung infection was suspected, thus allowing specific treatment and the avoidance of inappropriate antibiotic therapy.

The Chest Radiograph in Critically Ill Surgical Patients is Inaccurate in Predicting Ventilator-Associated Pneumonia

The purpose of this study was to determine if the interpretation of the CXR correlated with a diagnosis of VAP in SICU patients, and whether this improved the clinician's ability to diagnose VAP.

Comparison of nonbronchoscopic techniques with bronchoscopic brushing in the diagnosis of ventilator-associated pneumonia.

Nonbronchoscopic PSB and BAL provide similar microbiologic data to bronchoscopicPSB in the diagnosis of ventilator-associated pneumonia while shortening procedure time significantly.

Diagnostic accuracy of protected specimen brush and bronchoalveolar lavage in nosocomial pneumonia: impact of previous antimicrobial treatments.

After recent introduction of an antibiotic treatment for suspected ventilator-associated pneumonia, protected specimen brush and bronchoalveolar lavage culture thresholds must be decreased to maintain good accuracy.

Validation of different techniques for the diagnosis of ventilator-associated pneumonia. Comparison with immediate postmortem pulmonary biopsy.

The histopathology of immediate postmortem pulmonary biopsies, considered the "gold standard" reference test, is considered, and the sensitivities and specificities of different invasive techniques are much lower than those reported in clinical studies.

The diagnosis of ventilator-associated pneumonia: a comparison of histologic, microbiologic, and clinical criteria.

STUDY OBJECTIVE To evaluate histologic, microbiological, and clinical criteria in the recognition of ventilator-associated pneumonia (VAP) in patients who died while mechanically ventilated. …

Evaluation of clinical judgment in the identification and treatment of nosocomial pneumonia in ventilated patients.

The findings indicate that the use of clinical criteria alone does not permit the accurate diagnosis of nosocomial pneumonia in ventilated patients, and commonly results in inappropriate or inadequate antibiotic therapy for these patients.

Problems in diagnosing nosocomial pneumonia in mechanically ventilated patients: A review

Reviewing the available information about diagnosing nosocomial pneumonia in mechanically ventilated intensive care unit patients found two promising new diagnostic modalities are the protected specimen brush and bronchoalveolar lavage, both performed via flexible bronchoscopy.